Provider Demographics
NPI:1700226719
Name:BASES, ROBERT ERWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERWIN
Last Name:BASES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MOHEGAN PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1304
Mailing Address - Country:US
Mailing Address - Phone:914-633-7766
Mailing Address - Fax:914-632-3056
Practice Address - Street 1:1 MOHEGAN PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1304
Practice Address - Country:US
Practice Address - Phone:914-633-7766
Practice Address - Fax:914-632-3056
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-078046207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine